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Dr. Andrew Rynne

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My chest has felt tight for several days now, what is wrong with me ?

My chest has felt tight for several days now, what's wrong ? (I m 22, by the way) last week the doctor told me that my blood pressure was too high, that it was pre-hypertensive. around sunday my chest started to feel tight. I ve been dizzy, short of breath and pretty tired for the most part (although often I do not sleep as much as I should). Am I look at a serious heart disease? or do I just need to change my life style? I should note that, I ve been a pretty healthy person for the most part. (aside from asthma and a few bouts of tachycarida when I was younger). Up until 3 months ago I exercised regularly and tried to eat fairly healthy meals.
Fri, 11 Dec 2009
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The moment anyone even mentions chest pain on this forum a bunch of people freak and suggest you call 911 and/or go to the ER for immediate evaluation. The problem is that I doubt most people answering have any idea what true cardiac symptoms are or what to look for - which begs the question why they are answering in the first place? What are the prime cardiac risk factors? Hypertension, diabetes, smoking, high cholesterol, family history of pre-mature heart disease, and age over 65. What are your risk factors? "pre-hypertension" is not hypertension. Though you didn't say, I would guess therefore that your risk factors are zero. While not impossible to have heart disease at 22, you really have to work at it. There are the exceptions of people born with heart abnormalities/conditions and die on the practice field. In every case they were exerting beyond normal everyday activities. How does heart disease typically present? Chest fullness or tightness associated with activity and relieved with rest is the classic presentation. Emotional upset can also be a precipitating factor. Chest pain from your heart does not go on for days without worsening with intensifying symptoms - profuse sweating, nausea, vomiting, shortness of breath, and a sense of impending doom are common. Variants to chest discomfort are neck/jaw discomfort, shoulder, arm, elbow discomfort, burning central chest pain, mid-scapular pain among others. Cardiac chest pain is nearly always comes with shortness of breath. So your description gives us a couple of clues: 1. You sound very worried about unlikely events. That may imply that you are an anxious person. Panic attacks can present with seemingly very concerning symptoms but do not evolve to more serious things. 2. You don't mention it but your symptoms do sound asthmatic. If I were a betting man, I would put my dollar on one or both of the above diagnoses. I would make an appointment with my family doctor to discuss the matter. If your breathing gets labored do go to the ER as asthma is not anything to mess around with either. Finally to answer you question about lifestyle. Yes! Regardless of what you discover from this event, adjust you lifestyle now to incorporate healthy choices. Exercise, eating right, adequate sleep, moderate alcohol, and no smoking are all choices that will pay dividends for years and years to come. Good luck.
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